Healthcare Provider Details

I. General information

NPI: 1760070890
Provider Name (Legal Business Name): TRINAY VIRGINIA THOMAS MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2021
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 VAN HOUTEN AVE APT 206
PASSAIC NJ
07055-2000
US

IV. Provider business mailing address

435 VAN HOUTEN AVE APT 206
PASSAIC NJ
07055-2000
US

V. Phone/Fax

Practice location:
  • Phone: 973-699-1340
  • Fax:
Mailing address:
  • Phone: 973-699-1340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05204900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: